Top 5 Man Killers in Singapore

Top 5 Man Killers in Singapore (Extracted from Men's Health Online)

Despite the tremendous leaps by medical sciences in the last few decades, the incidence of chronic disease has spiralled upwards and they are now the major contributors of mortality the world over. Not surprisingly these chronic diseases, like cancer, heart disease and stroke, share many of the same risk factors, such as smoking, alcohol consumption, obesity and physical inactivity.

1. Cancer
Cancer tops the list of killers with every fourth reported death in Singapore being borne of a cancer-related cause. Lung cancer is the leading cause of cancer deaths among Singapore men followed by colorectal and liver cancers.

Lung cancer is more common in Chinese males, especially from late 40s onwards. Carcinogens in cigarette smoke are the main initiators of lung cancer and it is estimated that 85 percent of lung cancers are caused by cigarette smoke. Smokers have a 10-fold greater risk of dying from lung cancer as compared with nonsmokers, and in heavy smokers, this risk increases to 15- to 25-fold.

Colorectal cancer, the second most common cause of cancer deaths in Singapore, is also more common among Chinese males over 40. A family history of colorectal cancer, or familial adenomatous polyposis syndrome, puts an individual at a high risk and a history of inflammatory bowel diseases like Crohn’s disease and ulcerative colitis have also been associated with an increased risk.

One way to prevent colorectal cancer is to reduce risk factors associated with the disease. It is believed that diets low in fibre and high in animal fats are linked with an increased risk. A fibre-rich diet (four to five servings of fruits and vegetables and a restricted, one to two daily servings, of meat, fish or poultry) lowers your risk. Eating less red meat, reducing smoking and alcohol consumption, and taking vitamin supplement containing foliates and calcium also lower your risk.

Rectal bleeding or changes in bowel habits, such as constipation or diarrhoea are the red flags to watch out for and most cases of colorectal cancer are curable if diagnosed in the early stage. Currently, more than half the patients die from the disease. One sure fire way of detecting colon cancer early, according to Dr Wong, is to go in for regular colonoscopy. A colonoscopic examination is recommended every five years after one’s 50th birthday.

Liver cancer is the third most frequently diagnosed cancer among Singaporean males, making up close to 10 percent of all cancers. Established risk factors include chronic hepatitis B and C infection and chronic heavy alcohol consumption. This is one cancer that occurs more frequently in Singapore that in the developed western nations. The reason for this could be linked to the high prevalence of the hepatitis B virus in the local population. Dr Wong advises vaccination against hepatitis B as one of the ways to prevent this cancer. Furthermore, 1 in 25 men in Singapore regularly drink alcohol, over the long term these individuals are at an increased risk of developing alcoholic cirrhosis. Individuals with alcoholic cirrhosis are at an increased risk of developing hepatocellular cancer.

2. Hypertension
Hypertension is a silent killer that affects almost 30 percent of adult Singaporean men. “Hypertension is usually asymptomatic,” says Dr Poh Kian Keong, consultant cardiologist at the National University Hospital. “Very often, hypertension is picked up during a routine physical examination by a primary care physician or nurse. In most hypertensive patients, medications are required for optimal control.

However, adopting a healthy lifestyle should always be employed at the same time to better control the blood pressure. It can help to reduce the dose of medication required for good hypertension control. Dr Keong recommends that everyone should at least have their blood pressure (BP) checked once every year from age 21 and above, more frequently if there is a family history of hypertension or other coronary risk factors. An ‘opportunistic’ BP check, i.e., when a family doctor checks your BP whenever you consult him for any unrelated illness, also helps detect this killer early..

3. Heart Attack
When we clog our hearts with lipids and other gunk, it has to pump against an increased load to get the blood circulating in our bodies. Just like when your muscles bulge when you’re bench-pressing, your heart muscles increase in size when its forced to work harder against a load. Except you’re not building muscle here – the hypertrophied heart muscles have a higher requirement of blood and are thus prone to ischemic heart diseases.

Ischemic heart disease, in which the blood supply to the heart is compromised, is the second leading cause of death in Singapore, accounting for 18 percent of all deaths. Unfortunately, there are no sure-shot, quick-fire remedies that can be incorporated into a busy guy’s lifestyle to avert a heart attack. Adopting a long-term healthy lifestyle is the only way to prevent the onset of a heart attack. Lifestyle factors like not smoking, healthy eating habits with little fats, trans fats and cholesterol; less salt and sugar; and lots of fibres, vegetable and fruits, maintaining an ideal body weight and proper management of stress.

4. Stroke
Stroke is a manifestation of a cerebrovascular disease in which the blood supply to the brain is affected. It is presently the fourth leading cause of death in Singapore, accounting for approximately 10 to 12 percent of all deaths. Stroke can present itself in many forms – as a minor episode lasting less than 24 hours called transient ischemic attack (TIA), or a life threatening or disabling event that can even cause death.

“Heart conditions such as irregular heartbeats and heart attack put a person at an increased risk of a stroke,” cautions Dr Bernard Chan, a Consultant in the Neurology Division at NUH. Additionally, vascular risk factors such as high blood pressure, diabetes mellitus, high cholesterol levels and lifestyle practices such as smoking and a sedentary lifestyle also increases one’s risk. People who have experienced a TIA, a brief stroke-like episode such as weakness on one side of body, speech difficulty or visual loss but completely recover within a few minutes, are at particularly high risk of suffering from a complete stroke with permanent brain injury within the next few days. TIA victims should immediately consult their physicians to undergo further investigations and start appropriate treatment to prevent a stroke from occurring, cautions Dr Chan.

“Quit smoking, exercise regularly and stick to a healthy diet with more vegetables and fruit and less fat and carbohydrates,” suggests Dr Chan. This, together with regular health checks, especially at or above the age of forty, to screen for the presence of risk factors and regular treatment and follow up if you do suffer from any conditions is the best way to reduce the occurrence of these diseases.

5. Diabetes Mellitus
In Singapore, the prevalence of diabetes mellitus is 8.2 percent, with the Indians making up the bulk of that number. Diabetes mellitus is associated with high blood glucose levels; the elevated glucose level if left untreated can wreak havoc in almost every organ of the body. The long-term sequels to the disease include diseases of the heart, kidneys, and can cause blindness and even affect the nervous system. It is currently the eighth commonest cause of death accounting for 3 percent of all deaths in Singapore. Moreover, diabetes is one of the major contributors to ill health and is associated with a three-fold increase in mortality, mainly due to cardiovascular disease. Our genes play an important role and thus a family history of diabetes increases susceptibility to the disease. A simple blood test can detect diabetes; early diagnosis and aggressive treatment of diabetes can prevent or delay the progression of the major chronic complications. In our body the hormone insulin is responsible for lowering blood glucose levels. One would assume that a diabetic individual would have low insulin levels. But, in patients with Type-2 diabetes, the more common form of the disease that occurs in middle-aged individuals, the converse is true. What actually happens is that as a person becomes obese, their insulin requirement increases, consequently the body steps up its insulin production to meet the hiked up demand. Although initially a person is able to meet the increased requirement but as the individuals weight continues to increase the insulin demand simultaneously rises, until a stage is reached when the body despite producing more than the normal amount of insulin is unable to close the gap between insulin requirement and insulin production. At this stage, the blood glucose levels start rising and the person is diagnosed as diabetic.

Consequently, even modest weight loss can have a substantial impact in preventing diabetes; this is especially true for the 6.4 percent of the Singapore population who are obese. The Singapore Ministry of Health’s Clinical Practice Guidelines on Diabetes Mellitus 2006 underlines the importance of making individuals, at high risk for developing diabetes, aware of the importance of regular physical activity and weight loss.